The XX Factor

Why Women Stand to Gain the Most From Health Care Reform

A guest post from Jessica Arons, Director of the Women’s Health & Rights Program at the Center for American Progress :

Women have everything to gain if meaningful health care reform succeeds and everything to lose if it fails. Why? Because the current system discriminates against women in numerous ways.

Although men are slightly more likely to be uninsured, that is because women are more likely to qualify for a government program like Medicaid, which provides health insurance for the poor. While 39 percent of women receive insurance through their jobs, 25 percent obtain insurance as a dependent of a spouse, partner, or other relative. Receiving insurance through a spouse leaves women more vulnerable to losing their insurance if they divorce, or if their husband loses his job, becomes disabled, or passes away. And women who aren’t married usually cannot obtain insurance through another person, which helps explain why they account for 60 percent of uninsured women.

In addition, six percent of women have private insurance and 18 percent are uninsured, mostly because they can’t obtain decent, affordable coverage in the private market. And in that market, plans routinely engage in a practice known as ” gender rating ,” which means they charge women higher premiums than men of the same age and health status.

Private plans also commonly deny coverage for preexisting conditions that are unique to women or disproportionately affect them, such as being a survivor of domestic violence. And these plans rarely offer comprehensive maternity benefits. Here’s your baby! That will be $7,500, please, (for an uncomplicated vaginal birth in a hospital) and easily twice that or more for a C-section .

Women who have just about any kind of insurance typically have higher out-of-pocket costs than men. They are also more likely to be considered “underinsured,” meaning they have to spend more than 10 percent of their income on health care costs. Often that’s because women are more likely to suffer from a chronic condition, but it’s also because they have more routine health care needs, like an annual gynecological exam or a monthly co-pay for birth control. Indeed, during their reproductive years, women spend 68 percent more on health care than men.

But because women generally are paid less than men, they are less able to afford these extra payments. Unsurprisingly, women are more likely to delay seeking medical care because of cost concerns and also more likely to experience a medical bankruptcy .

And then there’s the pesky matter of abortion. From the media coverage (see here , here , and here ), you would think this is the only “women’s issue” in health care reform. It’s clearly not, but women should still be worried about it. Despite its much-debated moral dimensions, it is one of the most common medical procedures in this country. More than one of out three women in the United States will have had an abortion by the age of 45, and yet the chances of getting a health care bill without some carve-outs around abortion seem slim.

Currently 87 percent of typical employer-sponsored plans cover abortion, but women on Medicaid, in the military, in the federal government, on Native American reservations, and others receive no coverage for abortion unless a pregnancy threatens their life or is the result of rape or incest. One quarter of poor women carry an unwanted pregnancy to term because they cannot afford an abortion, and the rest must beg, borrow, or steal to raise the needed funds- $413 on average in the first trimester and potentially up to a few thousand dollars if later in the pregnancy.

Some members of Congress, recognizing the special stake women have in achieving meaningful health care reform, sponsored a resolution to that effect last year-among them, then-Senator Barack Obama. When the President visits his old stomping grounds and addresses Congress tonight, let’s hope he remembers to make the case for why women can’t wait for health care reform.

Photograph of woman at the doctor by Medioimages/Photodisc/Getty Images.